The complex mosaic of health promotion

The complex mosaic of health promotion

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World Tobacco Day

Tobacco smoking is a major contributor to cancers and respiratory diseases, but also has an impact on cardiovascular health of people worldwide. It is a key risk factor for the development of coronary heart disease, stroke and peripheral vascular disease. Since 2015, Community Works has contributed to the work of the National Best Practice Unit for Tackling Indigenous Smoking or NBPU-TIS. Tackling Indigenous Smoking (TIS) is a major program with the aim of reducing the numbers of Aboriginal and Torres Strait Islander people who smoke. Professor Tom Calma is National Coordinator for Tackling Indigenous Smoking and he regularly draws our attention to key facts on smoking on Australia, including the information below from the Australian Bureau of Statistics.
The Australian Government, through the Department of Health, supports TIS. Nearly forty organisations have joined this national effort and their teams design, implement and monitor a range of activities to raise awareness of the health effects of smoking and reduce numbers of Aboriginal and Torres Strait Islander people who smoke. The more we work on this program, the greater insights we gain on the complex and inspiring efforts of health promotion workers across the country. They run groups for pregnant women, produce and distribute materials in various forms, support champions and ambassadors for quitting smoking, promote smoke-free events, homes and workplaces, run social media campaigns and lead a wealth of creative activities all around Australia. As with good community development practice, it is often the ‘entry point’ to a discussion that is the most critical part of the process. Some organisations offer make-up sessions for women as a starting point for a discussion about health. Others have developed innovations like breakfast meet-ups to encourage men to think about the start of the day, which is often when smoking can replace good food, having further impacts on health. This year, the role of Community Works with the NBPU-TIS has been in the facilitation of six state and territory workshops for TIS plus one at national level, together with the delivery of training activities for health workers and related materials. This year World No Tobacco Day is on 31st May. The theme of the day is the impacts of smoking on the health of your heart. Coordinated by the team from Bega Garnbirringu Health Service, participants at the recent Western Australia state workshop and training day produced a video for World Tobacco Day. We are pleased to share it here:
The art of making toolkits

The art of making toolkits

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In the development sector, toolkits refer to a set of information that is brought together with the aim of providing guidelines for best practice or to orient the implementation of a model or service.

The art of making toolkits

During the past six months I have been involved in the process of developing a toolkit while working as part of the team of Community Works. In the development sector, toolkits refer to a set of information that is brought together with the aim of providing guidelines for best practice or to orient the implementation of a model or service. They contain one or more documents that present procedures and methodologies related with a given approach, as well as practical exercises, reflection questions or recommendations to be used as tools by implementers. Toolkits are helpful for organisations that are expanding or scaling up their model, serving as a way of transmitting the information and orienting decision-makers or program managers. Also as a training guide or textbook for field-based workers.

Throughout this process I noticed two ideas and I would like to share them with you. First, the knowhow and experience of Community Works has led its team to develop toolkits as an art. Knowing what needs to be done, Community Works has the capacity to facilitate a consultation process – not as a method that follows rigid steps, but as an artistic endeavor oriented to create a document as a product. This is similar to the case of an architect who goes through a creative process with the aim of designing a building or structure with a functional design.

Second, the toolkit development process has the power to generate an intangible and sometimes unexpected result: the growth and development of the organisations and actors involved. Besides creating documents and materials, the process itself operates as a platform for organisations to reflect and discuss, as well as bring together experiences and ideas. Toolkit development serves as a ‘mirror’ – reflecting gaps, strengths, and points where operational decisions need to be made. Although this might be confronting, it also serves as an invitation for development and growth.

Toolkits as an art

Approaching toolkit development as an art relies on the ability of learning the rules first. Throughout the experience of creating toolkits, Community Works’ members have learnt what works best. Examples are the importance of doing fieldwork and talking to those delivering and receiving the service, asking for the necessary documents and materials and knowing how to ask the right questions. Once it is clear how to combine these elements and how to navigate oceans of information, the possibility for creation intensifies. With experience comes the ability to identify patterns without trying to control the non-linearity and other characteristics that require an artist’s mindset to approach this process.

  • Non-linearity: Developing a toolkit requires constant consultation and discussion between the client and Community Works. Spoken dialogue is a key element of the process, especially at the early stages of the project. This might include Skype discussions, in-person workshops or phone conversations. Additionally, written drafts might go back and forth, exchanging comments and feedback. In some cases, it is necessary to come to previous versions and even re-write some sections. Rather than trying to look for a linear process, I learnt to embrace this non-linearity and sense the richness that this ‘messiness’ brings to the table.
  • Bringing the threads together: Creating a toolkit involves bringing together information from diverse sources as well as ideas from different people. Also, different clients and projects may require different approaches and it is only until the work begins that this becomes evident. There is no model for how to do this, so it requires the intuitive skill of an artist, weaving the threads that might seem ‘loose pieces’ to make a design that effectively delivers a message.
  • Language and writing style: Finding the appropriate ‘toolkit language’ and writing style requires time and sensitivity, as well as consultation with the client organisation.
  • Graphics, images and text: Every element of the toolkit has a reason for being there. It is meant to complement in a creative way the rest of the information in that same page. Finding the right balance is also part of the art.

The non-linearity of the process, the diversity of voices and information, the language, as well as the challenge of finding a balance between graphics, images and text, require more than following a recipe’s steps. Connecting the dots and bringing the different threads together is not the work of an isolated artist, or of Community Works on its own, but a process in which all the actors involved are immersed.

Toolkits as a mirror

Understanding toolkit development as a mirror, allows us to grasp its potential. Toolkits become an opportunity for growth since it is through the process of ‘telling the story’ that strengths, gaps and inconsistencies become evident. Besides allowing organisations to materialize their models, information and procedures to be shared with others, it serves as a platform for internal growth.

Has it happened to you that when ‘telling the story’ to others you might notice new elements you were not aware of before?

Well, something similar happens when developing a toolkit. Although things might seem clear and defined – divergent perspectives or things to be defined often show up. Furthermore, this process might bring together voices of people within an organisation that might have not shared a common space before. This is why toolkits might generate this ‘mirroring effect’, which might generate discomfort to the people and teams involved, including Community Works!

It was surprising to see how this ‘mirroring effect’ transcends the client/consultant divide, and turns into a process in which everyone is involved. In some cases Community Works asks questions or give recommendations that might contribute to the process of the client. However, in some occasions this happens the other way around. The questions and recommendations of the client end up enriching the content of the toolkit.

However – despite the temporary discomfort the process might bring, the good news is that it offers an opportunity for working out those situations. The urgency of decision-making needed for developing a toolkit, encourages the actors involved to discuss, reflect and decide what will be communicated in the documents. For example, some members of the client organisation might argue how partner organisations should follow the same data collection tools, while others will claim this is something for Project Managers to decide. During the process of making a toolkit this divergence might be identified, and members of the organisation are encouraged to make a decision with the aim of presenting this topic in a clear way.

Participating in a toolkit development process has been an inspiring experience, evidencing the richness that comes when bringing together different teams and groups of people. At the end, the mirror that reflects towards both sides evidences the power of dialogue between two individuals or groups of people. It is from this interaction, questioning and mirroring that gaps and tensions are identified. Although the process might be confronting, it also offers the possibility of growth by opening a space for discussion and negotiation. This also shows how dialogue serves to navigate chaos and messiness to arrive to a more clear, beautiful and functional design.

Community therapy? Parallels and distinctions between counselling and capacity building

Community therapy? Parallels and distinctions between counselling and capacity building

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“The parallels and distinctions between counselling and capacity building have helped me reflect on how to centre capacity-building processes around the strengths, knowledge, and experience possessed by people creating change in their communities” – Maria Rodrigues

Our colleague and Lead Researcher of Community Works, Maria Rodrigues has recently published a peer-reviewed article in the Community Development Journal, in which she discusses a parallel between capacity building in the context of community development and counselling in the context of psychotherapy. Based on this parallel Maria approaches the question: “can capacity building be conceptualized as community therapy?”

In a creative and rigorous way, Maria shares some of her experiences as a facilitator and reflects upon them by recalling elements from her psychology background. This brings to the table a different way of thinking about facilitation by comparing it to the way in which a counsellor might work with her or his clients. Using this analogy, Maria draws a parallel between a therapist, who helps individuals to cope with challenges and function better, and a facilitator, who helps groups to do the same in their communities.

A story… Maria introduces the parallel by describing the first time she facilitated a capacity-building workshop with a group of Indian Government Officials. Knowing little of the challenges and struggles they faced, she was plagued by self-doubt. What could she bring to the table? It turned out that it was her skills as a counsellor that were valued most by the group. This facilitating experience was not about her but it was about them. This gives rise to her reflection on how this analogy can be a useful way of thinking about facilitation and community capacity-building. We highlight the key points of this argument here.

Therapy and ‘Community Therapy’ as a healthy practice

Maria recalls her learning from psychology and how therapy “is not just for the sick” but also for “healthy, well-functioning individuals”. This implies an understanding of therapy as a process of reflection that helps us understand assumptions, identify barriers as well as find new and better ways of moving forward. From this perspective, therapy is beneficial for everyone at certain points of life. It is not about ‘fixing’ someone who is ‘broken’, and many times it is not even about healing the sick. Sometimes therapy is about helping healthy individuals meet extraordinary challenges or life transitions, just like development.

To explain this, Maria refers to the work of Sherry Arnstein (1968) and how this author says therapy and participatory planning might be ‘dishonest and arrogant’ when thinking these processes as ‘the cure’ for powerless and sick groups of individuals. Thus, a possible risk of thinking development processes as ‘therapy’ is to address groups or communities as ‘patients’ to be treated, ignoring the broader and structural development challenges that should be tackled as well. To avoid this pitfall, Maria argues community therapy should be addressed as a reflective process through which groups identify possible causes of their barriers to community development such as racism or discrimination. This allows groups to understand themselves as part of a system, acknowledging how barriers or difficulties might be part of a larger context and not necessarily something that should be fixed within them.

Accordingly, thinking about community therapy as part of development practice presents therapy as a platform for individuals and groups to prepare themselves, build the necessary capacities or practice possible tools to face and negotiate their situations or barriers as a group. Moreover, Maria argues how therapy should be a two-way process in which both counsellor and counselled or facilitator and facilitated are involved as equals- and not about an ‘expert’ imparting a process.

Contientization

Maria deepens her analysis by referring to the work of Paolo Freire and the concept of contientization, or ‘change of consciousness’. This idea suggests how citizens reflect on their realities as the first step towards making ‘their lives better’. Rather than a top-down approach proposed by an expert, these reflections should come from the communities, proposing an understanding of community development as a ‘transformation of mindset’.

Following this idea as well as the Liberation psychology framework influenced by Freire, this transformation implies a process of ‘unpacking’ or deconstructing live experiences as a ‘therapeutic process’. It is through this process of unpacking that a community might begin to liberate itself from oppression and injustice, as well as identify how to avoid further oppression.

Facilitators as community therapists

Maria recalls some of her personal experiences as a facilitator to show the parallel with her role as a counsellor and shares some of the counselling skills that have enriched her facilitation practice:

  • Identifying as an ‘outsider’ – The client, community or group are the experts about their lives and circumstances.
  • Active listening – As therapists do, facilitators are actively engaged and asking the necessary questions.
  • Awareness of multi-directional learning processes – It is not about a therapist healing clients but rather a two-way process of transformation.

Maria mentions how these parallels and distinctions have helped her to reflect on how to address capacity-building processes. Her paper invites our team to continually reflect about our practice as facilitators and ask further questions. How can we both facilitate and experience this process of transformation? How to do this when different cultural logics and mindsets come into play? We hope you enjoy Maria’s paper as we did and we extend this invitation to constantly reflect about how to practice and approach community development.

Reference: Rodrigues, M. (2017) Community therapy? Parallels and distinctions between counselling and capacity building. Oxford University Press and Community Development Journal Vol 52 No 2. pp. 372-377.

The problem of changing theories of change

The problem of changing theories of change

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The theory of change method of planning has rapidly grown in significance for organisations working in social and economic development.

Wherever I work these days, someone is developing a theory of change and I often get involved in the process.

It’s good because the whole approach helps us all to think about the cause-effect relationships that underlie the design of a project. For example, if an investment if to be made in local decision-making processes for using infrastructure budgets, the underlying theory is that local people will make more effective decisions on the use of funds than outsiders, leading to better results for the community.

Simply stating this theory and discussing it enables us to work out where the weakness in the logic might be found. In this case, can we be sure that local people have the technical knowledge to make infrastructure investment decisions? If not, then the project design needs to be changed to make sure that expertise is available to them in a timely and appropriate way.

I used ‘logic’ above, which is not a word associated with theories of change because they tend to be seen as an alternative to logic models. And logic models continue to be criticised as being linear engineering approaches to tackling messy, complex social problems. But a peculiarity of some theories of change is that they often look like logic models.

We have a problem, which is that the pure form of theory of change is being messed with. As a result, multiple methods are emerging and which have the same name but which are quite different in character. Here are three different types of theory of change I have seen recently:

  • Flow diagrams that show how one activity links to another over time, with boxes joined by arrows and not much in terms of testable theories shown.
  • Vertical logical frameworks turned on their side, complete with the usual input-activity-output connections in the middle.
  • A list of statements on how an action will lead to a result.

All the above were called theories of change.

Here’s a suggestion. Let’s use both logic models and theories of change for project design and planning processes. A theory of change is a way of testing the key cause and effect relationships that underpin the project. We ought to identify those relationships and work out whether there is evidence to support them. This is a good starting point for a conversation with a project team or a community group. For example, I was in a planning workshop and someone said ‘we need to get the elders to talk to young people about their anti-social behaviour’. The theory of change was that senior people talking to young people would lead to less anti-social behaviour.

It only took for this statement to be written on the board for people to start raising questions like ‘How do we know that young people listen to elders?’ or ‘Do the elders even want to do this?’. Once the testing of basic ideas had progressed for a while, we were ready to write a logic model. In this case, one of the activities prior to writing the logic model was to talk to a group of elders to find out whether and how they might be involved.

So, once all the theories of change are worked through, we ought to have a basis for preparing a much better design for a project than would have been the case. After that, using a logic model will be more effective as it should avoid us jumping to simple linear ‘solutions’ for social problems that simply may not respond that way.

Celebrating Christmas in Summer by Vanessa Angulo

Celebrating Christmas in Summer by Vanessa Angulo

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Earlier this year our Community Works Team had its yearly Christmas celebration. It was difficult to put all the calendars together and find a date where we all could be at the same place, at the same time. So, we decided the best time of the year for this was mid January, and gathered on a lovely sunny day in Melbourne for a yearly meeting, followed up by a social gathering including family and kids; ice-cream, a few drinks and pizzas. It was such a great opportunity to catch up with fellow team members, families… and meet new babies!

Community Works exists to help organisations working on community-oriented projects and programs to improve the quality and result of their activities. The company started in 2008; although, our Director, Steve Fisher, had been doing similar work for several years prior to that.

Our team consists of a very talented group of people with different skills, knowledge, experience and backgrounds. We gathered at a meeting room booked at the Abottsford Convent for a change, and discussed about all the different projects we have engaged in this year. 

The impact of the work we do at Community Works is growing through partnerships, new and existing regular clients; as well as, by developing a close relation with other development organisations and NGOs.

This year we hope to develop new partnerships, sign new agreements, keep working with our regular clients and to continue to contribute to great results and programs of high positive impact at local, national and international levels.

A group from RACI visiting the Akeyulerre Healing Centre with ELP in Alice Springs